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The biotech industry has reaped huge profits in recent years by developing custom drugs that treat a wide variety of conditions, including cancer and arthritis. The massive cost of some of these drugs has caused lawmakers and insurance companies to push back. So it was big news today when pharmacy benefit-manager Express Scripts announced it was switching to a new hepatitis C drug by a different manufacturer.

At around $84,000 for a 12-week course of therapy, Express Scripts dropped the drug Sovaldi and its maker Gilead Sciences Inc., in favor of a new hepatitis C drug offered at a discount by rival company AbbVie. Even though having multiple drugs to choose from is a good thing, some clinicians say exclusive arrangements, like the one Express Scripts brokered with AbbVie, are not always best for the patient. 

"We don't want to have our hands tied, to be told that we can only offer drug A or drug B, because there may be a reason that the one that's not offered may be preferable to the patient in front of you," says Dr. Robert Fontana, a professor of hepatology at the University of Michigan.

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Follow Adam Allington at @@aallington